PERCUTANEOUS BALLOON OCCLUSION OF LVAD OUTFLOW CANNULA TO EVALUATE MYOCARDIAL FUNCTION RECOVERY

Off-pump trials to evaluate myocardial recovery in patients with idiopathic dilated cardiomyopathy (DCMP) supported by continuous-flow pumps might be more challenging than with pulsatile-flow devices because of retrograde flow through the left ventricular assist device (LVAD). The estimated recovery rate is about 5% within five years. We present the case of a young girl suffering with chemotoxic cardiomyopathy. She developed cardiogenic shock and was initially bridged from extracorporeal life support (ECLS) to a durable LVAD. After two years of LVAD support, echocardiography at low RPMs showed evidence of reverse remodeling. However, significant regurgitation through the pump during right heart catheterization (RHC) would have prevented an optimal assessment of myocardial function, therefore an off-pump trial and percutaneous balloon occlusion of LVAD outflow cannula was conducted in a hybrid operating room to evaluate the chance of pump explant.